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A Brief Educational Intervention Enhances Basic Cancer Literacy Among Kentucky Middle and High School Students.

ABSTRACT: Kentucky experiences the highest overall cancer incidence and mortality rates in the USA with the greatest burden in the eastern, Appalachian region of the state. Cancer disparities in Kentucky are driven in part by poor health behaviors, poverty, lack of health care access, low education levels, and low health literacy. Individuals with inadequate health literacy are less likely to participate in preventive measures such as obtaining screenings and making healthy lifestyle choices, thus increasing their chances of developing and dying from cancer. By increasing cancer literacy among youth and adults, it may be possible to decrease cancer disparities across Kentucky. This study aimed to establish connections with middle and high schools in Kentucky that would facilitate pilot implementation of a brief cancer education intervention and assessment of cancer health literacy among these student populations. A baseline pretest cancer literacy survey consisting of 10 items was given to 349 participants, followed by the delivery of a cancer education presentation. Immediately following the presentation, participants were given a posttest with identical items to the pretest. Participants were primarily Caucasian (89.4%), female (68.7%), and in 10th through 12th grade (80.5%). Significant (p < 0.0001) increases in both average and median percent of correctly marked items were observed between the pretest and posttest (average, pretest = 56% versus posttest = 85%; median, pretest = 60% versus posttest = 90%). The scores for all individual items increased after the brief intervention. The results demonstrated a significant increase in cancer literacy levels immediately after the pilot educational intervention. We suggest that it may be possible to improve cancer literacy rates in Kentucky by integrating cancer education into middle and high school science and/or health education curricula. This could ultimately drive changes in behaviors that may help lower cancer incidence and mortality rates. Plans for future interventional studies measuring long-term cancer knowledge retention and resultant behavioral changes among middle and high school students as well as the feasibility of integrating cancer education into middle and high school curricula are also discussed.

SUBMITTER: Hudson L

PROVIDER: S-EPMC7388006 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:ObjectivesAlthough cancer is seen in every state in the United States, it does not affect every geographic area and population equally. Kentucky has the highest cancer incidence and mortality rates in the country, with an unusually high number of cases localized in its Appalachian region. Risk factors such as sun exposure, tobacco use, poor diet/exercise, poverty, and lack of access to healthcare centers contribute to this disparity. Because education levels in the area are low, cancer literacy (defined as how well a person can understand the advice of a healthcare professional and make appropriate lifestyle decisions) also is low. In this study, we examined the short-term and long-term effects of a brief cancer-related intervention on the cancer literacy of Kentucky middle and high school students.MethodsThis study targeted middle and high school students in Kentucky. We administered an online 10-item cancer literacy pretest, followed by a brief educational intervention and a posttest to 164 students at six Kentucky middle and high schools. This posttest also included questions asking how likely students would be to change their habits or to encourage others to change their habits as a result of the intervention. All of the participating students also were sent a 3-month follow-up online survey with items identical to the pretest; 48 students completed the 3-month follow-up test, leading to a response rate of 29.2%. The data were summarized as frequencies, averages, median, and confidence intervals (CIs) of correctly marked answers. A paired t test was used to test for significance.ResultsWe observed an increase in the overall average test score from 50.2% (95% CI 47.8%-52.6%) on the pretest to 77.1% (95% CI 74.6%-79.7%) on the posttest immediately following the intervention. There also was an increase in the average number of correct responses on each item. The 3-month follow-up test similarly showed average test score improvement (75.4%). When asked how likely students would be to change their habits as a result of the intervention on a scale from 1 to 10 (1 = extremely unlikely, 10 = extremely likely), the median was 6. When asked how likely students would be to encourage another to change their habits, the median was an 8.ConclusionsThese results provide evidence that a brief educational intervention can increase cancer literacy, improve cancer knowledge retention, and encourage behavior change in Appalachian Kentucky students. Increasing cancer literacy may result in increased participation in preventive cancer screenings and improved health habits, which could ultimately lower cancer rates in the region.

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A Brief Educational Intervention Enhances Basic Cancer Literacy Among Kentucky Middle and High School Students.

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